Impact of different anesthetic protocols during anesthesia for the establishment of a porcine model of acute kidney injury.

BACKGROUND

During the establishment of a model of acute kidney injury (AKI) in pigs, we observed a high prevalence of malignant hyperthermia (MH). These complications led us to refine the anesthetic protocol. This publication describes the impact of the choice of anesthetics on the results obtained.

METHODS

Pigs were euthanized at the end of the procedure, without recovery from anesthesia. Three anesthetic protocols were used: sevoflurane inhalation (ProtocolA, n = 5), a combination of ketamine, medetomidine and diazepam by intravenous infusion (ProtocolB, n = 5), and a combination of ketamine, diazepam, medetomidine, glucose, and noradrenaline (ProtocolC, n = 5). All pigs received morphine for analgesia. AKI was induced by interrupting renal perfusion for 90 min. MH was diagnosed based on clinical and biological parameters.

RESULTS

All MH pigs belonged to ProtocolA. MH pigs showed significantly higher maximum rectal temperature (p = 0.04), maximum expired carbon dioxide (CO2; p = 0.04), maximum heart rate (HR; p = 0.03), plasma concentration of creatinine and potassium (p < 0.0001). Protocol A pigs had a significantly higher maximum HR (p = 0.01) and hyperkalemia compared to the two other groups (ProtocolB, p = 0.005 and ProtocolC, p < 0.0001). Pigs from ProtocolA had a significantly lower minimum mean arterial pressure (MAP) than ProtocolC group (p = 0.03) and MAP remained below 60 mmHg for longer (p = 0.004). In ProtocolB, minimum glycemia was lower than other groups (p = 0.01).

CONCLUSION

Sevoflurane use was associated with the occurrence of MH, hemodynamic alterations and changes in plasma concentration of creatinine and potassium. These modifications can have a major impact on the validation of an experimental AKI model.